3 Questions to Ask Yourself Before Choosing a Sex Addiction Treatment Program

Neil Strauss went from a dateless, lonely high schooler to the ultimate pickup artist. He literally wrote the book on seduction, The Game: Penetrating the Secret Society of Pickup Artists, which spent two months on the New York Times Bestseller List.

A decade later, Strauss documented his stint in sex addiction rehab and his long, convoluted path to emotional health in The Truth: An Uncomfortable Book About Relationships. While each person’s path to healing is different, Strauss’ insights may help people struggling with sex addiction find the right kind of help for their needs. Start by asking yourself these questions:

#1 Does the 12-step approach resonate with you?

The 12-step approach of Alcoholics Anonymous has been effective for millions and is one of the most widely understood and used approaches to recovery from all types of addictive and compulsive behaviors. Meetings are available in most areas of the country and provide the structure and support many need to overcome addiction. But this approach doesn’t resonate with everyone. And since the majority of treatment centers use a 12-step model, it’s important to know before choosing a sex addiction rehab whether this approach is a match for you.

For Strauss, the 12-step approach didn’t resonate. He grew up with an enmeshed parent who expected him to keep secrets and take responsibility for their happiness. “The thing about enmeshment is it’s so hard to recognize”, says Strauss. “Unlike abandonment and certain kinds of abuse which are disempowering, it’s empowering when a parent confides in you and makes you another parent. There’s a special connection but you feel guilty and confused, having been robbed of an appropriate connection with your parent and a healthy childhood.”

Strauss spent a year white-knuckling it through 12-step meetings, getting a sponsor and doing workbook assignments before he realized he needed something different. “I had seen the 12-step model work for so many friends, but I was going out of my mind at meetings,” he says. “For many of us with trauma arising from an uncompromising, narcissistic parental figure, the rigidity of 12-step plays into the trauma rather than offering a solution.”

D. Bradley Jones, PsyD, LCSW, published a study exploring the ways in which the “implicit pull for conformity” in 12-step approaches can be problematic for people who grew up with an enmeshed parent. A negative reaction can occur for two reasons, writes Dr. Jones. First, conforming to “the program” may remind the person struggling with addiction of the demands of their intrusive caregiver. Second, the approach may pull the person back into unhealthy patterns of accommodation learned early in life. In either case, the 12-step approach may not be effective.

#2 Are your expectations of treatment realistic?

Strauss begins The Truth with a detailed account of his days in sex addiction rehab — an experience that ended with him leaving early against medical advice. He left believing that he didn’t have a problem and that a relationship with fewer illogical rules would be a better match for him. He tried open relationships, swinging, harems, communes, polyamory — each time arriving at the same disastrous end. Over time, he realized that it wasn’t his relationships that were broken, it was him. He explored other treatments and came to the realization that “Rehab works, but not always in the four- to six-week window that it’s designed to,” says Strauss.

If he were giving advice to a friend, Strauss would recommend charting a treatment plan that lasts at least a year. “You don’t check into rehab, get all your problems solved and then come out sober,” he explains.

Treatment should include 12-step involvement, if it resonates, as well as doing “deep feeling work” with intensive approaches to address trauma and heal the core issues. If you expect it to be quick or easy, you’re setting yourself up for failure. “It’s not going to feel good,” warns Strauss. “You have to tear down your defenses to feel the pain inside. You’ll feel raw and irritable. You’ll question whether treatment is working and why it’s making you more miserable than you were before. But you have to work through it until you no longer need those defenses.”

#3 Do you have a trauma history you haven’t yet addressed?

Many people struggling with sex addiction have a history of early life trauma. For Strauss, one of the keys to healing from the trauma of his childhood was active, experiential therapies. “What’s great about the addiction community is that it uses therapies that work, even if they’re new and not yet fully proven by research, because lives are at stake,” he says.

Some of the most powerful tools for his healing were somatic experiencing, EMDR, chair work and psychodrama, which Strauss strongly advocates should be available to all, including those who aren’t struggling with addictions. “I don’t think there’s anybody on the planet who wouldn’t benefit from doing the core healing and trauma work that is part of the recovery community,” he says.

Trauma work helped Strauss see himself more clearly. He developed tools to intervene on the lies and stories he told himself like “I’m not good enough” or “No one understands me” and effectively “reparent” himself so he could assess whether those beliefs were grounded in fact or based on false messages he internalized early in life. This ability to rewrite his internal dialogue, in turn, helped him stop the shame spiral so common in people struggling with sex and intimacy disorders. “It was a process of taking down defenses that were in place to protect me from threats that are no longer there, and drawing boundaries with my parents so I could heal without constantly getting re-traumatized,” he explains.

The Rewards That Await

Today, Strauss is married, has a son and has more happiness (and better sex) than he believed possible. He prioritizes self-care and holding himself accountable through group therapy. “All the things I was afraid of have turned out to be the best things in my life,” he says. “It’s insane how much energy I expended resisting something that led to the greatest happiness of my life.”

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